Frequently Asked Questions or What Can You Expect?
The vascular lab is a specialty area of Radiology that focuses on testing for possible circulation problems. Depending on what symptoms a patient presents with, the exam may be performed to look for problems with circulation in the arteries (blood vessels taking blood away from the heart), veins (blood vessels bringing blood back toward the heart), or both.
In the Vascular Lab, ultrasound is used to specifically look for circulation (blood flow) problems throughout the body. Below you will find information about what blood vessels and what parts of the body we evaluate, as well as what kind of problems we might be looking for. The specific type of testing ordered by a doctor is based on what type of symptoms a patient might be describing.
- What types of blood vessels are evaluated in the Vascular Lab?
- Arteries – This is the system of blood vessels that take blood away from the heart and deliver it throughout the body. Oxygen and nutrients are vital to all the organs and tissue throughout our body. Problems with circulation in the arterial system can prevent organs, body parts, and tissue from functioning properly and/or repairing itself after an injury.
- Veins – This is the system of blood vessels that bring blood back toward the heart and lungs. The majority of the oxygen and nutrients have been used up at this point, and the blood needs to be “recharged” so that it can be sent out again through the arterial system.
- Distinguishing new problems versus old problems
- Ultrasound can be a very useful tool in determining whether circulation problems are new or old. Blockages in the blood vessels will normally have characteristics (what the blockage looks like on the screen) that aid the reading physician in determining if a blockage is new or old. The technologist will also ask the patients to describe what symptoms (problems) they are having, how severe they are, and how long they have been going on. This information is used, along with the data gathered during testing, to assist the physicians as they try to help patients manage their medical needs.
- Acute – In medical terms, acute means “of abrupt onset”. Many symptoms of vascular problems can come on suddenly. Some symptoms are minor, some are severe, and some can be life changing or life threatening. Acute problems can occur in either the arterial system or the venous system, and are often considered High Priority exams in the vascular lab because timely treatment or additional testing can be critical to patient care.
- Chronic – In medical terms, chronic means “lasting a long time”. Like acute problems, chronic problems can also be found in either the arterial or venous system. A number of circulation problems can take weeks, months, years, or even decades before causing significant enough symptoms to lead someone to seek medical attention.
The Vascular lab evaluates blood vessels, arteries and veins, in the neck, arms, abdomen, and legs. Many of the exams involve imaging of specific blood vessels with duplex ultrasound. Some exams are performed without imaging the blood vessels. These studies, physiologic exams, rely on non-imaging techniques such as comparison of pressure measurements at multiple locations. Physiologic testing can offer information about circulation through very small vessels such as those in the fingers or toes.
No. Vascular lab testing is done with the use of various forms of ultrasound. With ultrasound, a probe is placed on the skin surface and sound waves are sent in to the body. Those sound waves bounce off everything under the skin (tissue, bone, muscle, blood vessels, etc..). The sound waves that return to the ultrasound probe are used by the ultrasound machine to create an image of what is below the surface. Ultrasound is a very safe technology.
Exam time can vary greatly depending on what information needs to be gathered, and how easy or hard that information is to gather on any particular patient. Most vascular lab exams are scheduled for 60 minutes, and some of the most complicated exams can be scheduled for up to 120 minutes. The technologists will do their best to work in an efficient manner, without sacrificing patient care, but it is very difficult to determine exactly how long any patient should expect to be on an exam gurney.
In general, no, an ultrasound exam is not a terribly uncomfortable exam. However, in order to provide a high quality diagnostic exam, and gather the best possible information to help confirm whether there is a problem with the circulation, exams may require the technologist to use a moderate amount of pressure through some parts of the test. The technologist is responsible for explaining what they will be doing during each specific exam, express whether any discomfort might be expected during the exam, and to be attentive to every patients needs if the individual is unable to tolerate any part of the study. The information being gathered is potentially critical to providing accurate exam results, so we always encourage patients to work with us as much as possible while we go through the study.
There is a wide variety of circulation problems that the vascular lab can help evaluate for. The type of symptoms that a patient presents with will dictate what type of exam is performed. Some patients present with symptoms that have come on quickly, and may be life threatening, such as symptoms of a stroke, mini-stroke, Deep Vein Thrombosis (DVT), or arterial blood clot. Other patients present with problems that have progressively worsened over time, but are not necessarily life threatening, such as long term narrowing of arteries at different areas of the body or bulging veins (varicose veins) in the legs. Ultrasound, when performed by a qualified technologist, is a very safe and highly effective tool for identifying the location and severity of vascular problems throughout the body.
Yes. Vascular testing is very complex, and the accuracy of vascular lab testing is highly dependent on the education and experience of the individual (technologist) performing the exam. At UC Davis we require that all technologists obtain, and annually maintain, the Registered Vascular Technologist (RVT) credential through the American Registry for Diagnostic Medical Sonography (ARDMS). All vascular technologists are included in ongoing quality assurance and quality improvement efforts to ensure that both knowledge and technical skills are maintained at a very high level. The UC Davis vascular lab also maintains vascular testing accreditation through the Intersocietal Accreditation Commission (IAC). The accreditation process involves an intensive review of policies and procedures, testing methods, medical and technical staff qualifications, and exam quality. Only a small percentage of facilities that perform vascular testing dedicate the time and effort necessary to obtain and maintain IAC accreditation. IAC accreditation is another mechanism the UC Davis Vascular Lab uses to demonstrate its commitment to the quality of care being provided to every patient.
A technologist will perform the exam, which then goes to a designated vascular lab physician for review and interpretation. The technologist may often be able to answer some questions individuals might have about the exam, but the formal results will not be provided by the performing technologist. A final report will typically be in a patients chart in less than 24 hours. For individuals who utilize the UC Davis My Chart web site, Radiology results should be present 4-5 days after exam completion and interpretation.
The vascular technologist is not able to provide patients with a copy of the exam directly from the ultrasound machine. However, both the Radiology Film Library and the Medical Records department have the ability to put the exam files on a DVD at the patients request.
Please contact Radiology scheduling at (916)734-0655 for specific instructions based on the type of exam that has been ordered. As a general rule, the vascular lab requests that all patients having an exam that involves scanning the abdomen, be fasting for at least 4-6 hours prior to the exam. This helps minimize the amount of abdominal bowel gas, and often significantly improves the ultrasound image quality. Patient safety is first priority though, and the vascular lab does not want patients to refrain from taking prescribed medications. Food and/or water should be consumed in accordance with medication guidelines. For any exam being performed elsewhere on the body (neck, arms, legs), there are no dietary restrictions prior to testing.